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Microorganisms
Special Issues
Infections in Pregnancy and Pathology Findings
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Infections in Pregnancy and Pathology Findings

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 14078

Special Issue Editor

Dr. Maria Paola Bonasoni

E-Mail Website
Guest Editor
Azienda Unità Sanitaria Locale—IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
Interests: prenatal infections; pregnancy; fetal histopathology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Prenatal infections may occur at any time during pregnancy and their complications include intrauterine fetal death, preterm birth, morbidity, mortality, and long-term sequelae in newborns. The most common organisms are viruses, bacteria, fungi, and protozoa. They can reach the fetus and the placenta through several pathways such as the ascending route (along the endocervical canal), from maternal blood or invasive procedures (amniocentesis).

According to the etiologic agent, histopathological findings in the placenta and fetus may vary and some may be unique to the pathogen involved. Especially in stillbirth, recognizing typical features, either grossly or histologically, may play a key role in finding the specific agent and planning future pregnancies. On the other hand, placental examinations in septic newborns may be fundamental in discovering the responsible pathogen, tailoring maternal and neonatal treatment.

This Special Issue of Microorganisms aims to present a collection of articles that examine the pathological findings of the various microorganisms in the fetus and in the placenta. Manuscripts covering all aspects of histopathology of infections in pregnancy, their outcome, and management are welcome.

Dr. Maria Paola Bonasoni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prenatal infection
  • pregnancy
  • fetus
  • placenta
  • microorganisms
  • infection
  • histopathological findings

Published Papers (7 papers)

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Research

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15 pages, 301 KiB  
Article
Placental Characteristics of a Large Italian Cohort of SARS-CoV-2-Positive Pregnant Women
by Michele Antonio Salvatore, Edoardo Corsi Decenti, Maria Paola Bonasoni, Giovanni Botta, Francesca Castiglione, Maria D’Armiento, Ezio Fulcheri, Manuela Nebuloni, Serena Donati and the ItOSS COVID-19 Working Group
Microorganisms 2022, 10(7), 1435; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms10071435 - 15 Jul 2022
Cited by 11 | Viewed by 1673
Abstract
The variety of placental morphological findings with SARS-CoV-2 maternal infections has raised the issue of poor agreement in histopathological evaluation. The aims of this study were: to describe the histopathological placental features of a large sample of SARS-CoV-2-positive women who gave birth in [...] Read more.
The variety of placental morphological findings with SARS-CoV-2 maternal infections has raised the issue of poor agreement in histopathological evaluation. The aims of this study were: to describe the histopathological placental features of a large sample of SARS-CoV-2-positive women who gave birth in Italy during the COVID-19 pandemic, to analyse the factors underlying these lesions, and to analyse the impact of placental impairment on perinatal outcomes. From 25 February 2020 to 30 June 2021, experienced perinatal pathologists examined 975 placentas of SARS-CoV-2-positive mothers enrolled in a national prospective study, adopting the Amsterdam Consensus Statement protocol. The main results included the absence of specific pathological findings for SARS-CoV-2 infections, even though a high proportion of placentas showed signs of inflammation, possibly related to a cytokine storm induced by the virus, without significant perinatal consequences. Further research is needed to better define the clinical implications of placental morphology in SARS-CoV-2 infections, but the results of this large cohort suggest that placentas do not seem to be a preferential target for the new Coronavirus infection. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
10 pages, 509 KiB  
Article
Impact of HAART Therapy and HIV Infection over Fetal Growth—An Anthropometric Point of View
by Daniela Roxana Matasariu, Mircea Onofriescu, Elena Mihalceanu, Carmina Mihaiela Schaas, Iuliana Elena Bujor, Alexandra Maria Tibeica, Alexandra Elena Cristofor and Alexandra Ursache
Microorganisms 2022, 10(6), 1123; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms10061123 - 30 May 2022
Cited by 2 | Viewed by 1584
Abstract
Human immunodeficiency virus (HIV) infection cannot be completely eliminated from the body because the virus integrates its genetic code into that of the host cell. The prevalence of pregnancy in women with HIV infection has increased due to the efficacy of antiretroviral therapy [...] Read more.
Human immunodeficiency virus (HIV) infection cannot be completely eliminated from the body because the virus integrates its genetic code into that of the host cell. The prevalence of pregnancy in women with HIV infection has increased due to the efficacy of antiretroviral therapy (ART). Placental insufficiency is associated with a reduction in blood flow and circulatory redistribution, resulting in fetal hypoxia and nutrient deprivation as a consequence of an altered placental function, and it can result in a lower birthweight. The aim of the study was to determine the combined effect of HIV infection and ART on the anthropometric parameters of infants born to HIV-positive pregnant women under ART compared to the values of these parameters in a control group of infants born to healthy mothers. There are no significant differences between the two groups in terms of gestational age at birth. We found a statistically significant lower birth weight in infants born from HIV-positive mothers under ART, with 3041 g in the control group compared to 2758 g in the group of HIV positive pregnant women (p < 0.01). There were statistically significant differences in all anthropometric parameters, these showing higher values in the control group (seronegative pregnant women). Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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Review

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11 pages, 632 KiB  
Review
Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review
by Elena Giovannini, Maria Paola Bonasoni, Jennifer Paola Pascali, Arianna Giorgetti, Guido Pelletti, Giancarlo Gargano, Susi Pelotti and Paolo Fais
Microorganisms 2023, 11(4), 1010; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms11041010 - 12 Apr 2023
Cited by 1 | Viewed by 2297
Abstract
Fetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory response to amniotic fluid infection, acute funisitis and [...] Read more.
Fetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory response to amniotic fluid infection, acute funisitis and chorionic vasculitis. FIRS involves many molecules, i.e., cytokines and/or chemokines, able to directly or indirectly damage fetal organs. Therefore, due to FIRS being a condition with a complex etiopathogenesis and multiple organ dysfunction, especially brain injury, medical liability is frequently claimed. In medical malpractice, reconstruction of the pathological pathways is paramount. However, in cases of FIRS, ideal medical conduct is hard to delineate, due to uncertainty in diagnosis, treatment, and prognosis of this highly complex condition. This narrative review revises the current knowledge of FIRS caused by infections, maternal and neonatal diagnosis and treatments, the main consequences of the disease and their prognoses, and discusses the medico-legal implications. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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15 pages, 1196 KiB  
Review
Advances in Research on the Relationship between Vaginal Microbiota and Adverse Pregnancy Outcomes and Gynecological Diseases
by Fuju Zhao, Xianyang Hu and Chunmei Ying
Microorganisms 2023, 11(4), 991; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms11040991 - 11 Apr 2023
Cited by 2 | Viewed by 2769
Abstract
The human microbiota inhabiting different parts of the body has been shown to have a significant impact on human health, with the gut microbiota being the most extensively studied in relation to disease. However, the vaginal microbiota is also an essential commensal microbiota [...] Read more.
The human microbiota inhabiting different parts of the body has been shown to have a significant impact on human health, with the gut microbiota being the most extensively studied in relation to disease. However, the vaginal microbiota is also an essential commensal microbiota in the female body that plays a crucial role in female health. Despite receiving less attention than gut microbiota, its importance in regulating reproductive immunity and its complex dynamic properties have been increasingly recognized in recent years. Advances in research on the relationship between vaginal microbiota and pregnancy outcomes & gynecological diseases in women have shed light on the importance of maintaining a healthy vaginal microbiota. In this review, we aim to compile recent developments in the study of the vaginal microbial ecosystem and its role in female health and reproductive outcomes. We provide a comprehensive account of the normal vaginal microbiota, the association between the vaginal microbiota and pregnancy outcomes, and the impact of the vaginal microbiota on gynecological diseases in women. By reviewing recent research, we hope to contribute to the advancement of academic medicine’s understanding of the vaginal microbiota’s importance in female health. We also aim to raise awareness among healthcare professionals and the general public of the significance of maintaining a healthy vaginal microbiota for better reproductive health and the prevention of gynecological diseases. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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Other

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11 pages, 1208 KiB  
Brief Report
A Case of Persistent Human Pegivirus Infection in Two Separate Pregnancies of a Woman
by Mathieu Garand, Susie S. Y. Huang, Lisa S. Goessling, Donna A. Santillan, Mark K. Santillan, Anoop Brar, Todd N. Wylie, Kristine M. Wylie and Pirooz Eghtesady
Microorganisms 2022, 10(10), 1925; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms10101925 - 28 Sep 2022
Cited by 1 | Viewed by 1888
Abstract
Human pegivirus (HPgV) is best known for persistent, presumably non-pathogenic, infection and a propensity to co-infect with human immunodeficiency virus or hepatitis C virus. However, unique attributes, such as the increased risk of malignancy or immune modulation, have been recently recognized for HPgV. [...] Read more.
Human pegivirus (HPgV) is best known for persistent, presumably non-pathogenic, infection and a propensity to co-infect with human immunodeficiency virus or hepatitis C virus. However, unique attributes, such as the increased risk of malignancy or immune modulation, have been recently recognized for HPgV. We have identified a unique case of a woman with high levels HPgV infection in two pregnancies, which occurred 4 years apart and without evidence of human immunodeficiency virus or hepatitis C virus infection. The second pregnancy was complicated by congenital heart disease. A high level of HPgV infection was detected in the maternal blood from different trimesters by RT-PCR and identified as HPgV type 1 genotype 2 in both pregnancies. In the second pregnancy, the decidua and intervillous tissue of the placenta were positive for HPgV by PCR but not the chorion or cord blood (from both pregnancies), suggesting no vertical transmission despite high levels of viremia. The HPgV genome sequence was remarkably conserved over the 4 years. Using VirScan, sera antibodies for HPgV were detected in the first trimester of both pregnancies. We observed the same anti-HPgV antibodies against the non-structural NS5 protein in both pregnancies, suggesting a similar non-E2 protein humoral immune response over time. To the best of our knowledge, this is the first report of persistent HPgV infection involving placental tissues with no clear indication of vertical transmission. Our results reveal a more elaborate viral-host interaction than previously reported, expand our knowledge about tropism, and opens avenues for exploring the replication sites of this virus. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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8 pages, 2229 KiB  
Case Report
Unexpected Vertical Transmission of SARS-CoV-2: Discordant Clinical Course and Transmission from Mother to Newborn
by Alessandra Boncompagni, Mattia De Agostini, Licia Lugli, Giliana Ternelli, Valeria Colonna, Emanuela Biagioni, Maria Paola Bonasoni, Tiziana Salviato, Liliana Gabrielli, Mirella Falconi, Fabio Facchinetti and Alberto Berardi
Microorganisms 2022, 10(9), 1718; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms10091718 - 26 Aug 2022
Cited by 5 | Viewed by 1190
Abstract
Mother-to-newborn COVID-19 transmission is mainly postnatal, but single-case reports and small case series have also described SARS-CoV-2 transplacental transmission. Unfortunately, studies regarding vertical transmission of SARS-CoV-2 lack systematic approaches to diagnosis and classification. So far, scientific evidence seems to suggest that the severity [...] Read more.
Mother-to-newborn COVID-19 transmission is mainly postnatal, but single-case reports and small case series have also described SARS-CoV-2 transplacental transmission. Unfortunately, studies regarding vertical transmission of SARS-CoV-2 lack systematic approaches to diagnosis and classification. So far, scientific evidence seems to suggest that the severity of maternal infection increases the risk of vertical transmission. We report two neonates born from COVID-19-positive mothers, of which one of the newborns had a vertical infection. The placental involvement, and consequent intrauterine transmission of SARS-CoV-2, were inversely related to the severity of the maternal disease. The description of cases divergent from current evidence on this topic could provide new insights to better understand SARS-CoV-2 vertical transmission. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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11 pages, 3816 KiB  
Case Report
Congenital Syphilis Presenting with Brain Abnormalities at Neuroscan: A Case Report and a Brief Literature Review
by Gabriele Tonni, Gianpaolo Grisolia, Marlene Pisello, Paolo Zampriolo, Valeria Fasolato, Paola Sindico, Edward Araújo Junior and Maria Paola Bonasoni
Microorganisms 2022, 10(8), 1497; https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms10081497 - 25 Jul 2022
Viewed by 2047
Abstract
A case of vertical transmission in a 35-year-old pregnant woman, gravida 4, para 2 with an unknown medical history of carrying primary syphilis is described. A routine 3rd trimester scan was performed at 30 + 5 weeks of pregnancy, which revealed fetal growth [...] Read more.
A case of vertical transmission in a 35-year-old pregnant woman, gravida 4, para 2 with an unknown medical history of carrying primary syphilis is described. A routine 3rd trimester scan was performed at 30 + 5 weeks of pregnancy, which revealed fetal growth restriction (FGR) associated with absent fetal movement, a pathologic neuroscan characterized by cortical calcifications and ominous Doppler waveform analysis of the umbilical artery and ductus venosus. Computerized electronic fetal monitoring (EFM) showed a Class III tracing, according to the American College of Obstetricians and Gynecologists (ACOG) guidelines. An emergency C-section was performed and a female newborn weighing 1470 g was delivered. The Apgar scores were 5 and 8 at the first and fifth min, respectively. Besides the prompted obstetrical and neonatal interventions, the neonate died after 7 days. A histologic examination of the placenta revealed a chorioamnionitis at stage 1/2 and grade 2/3. The parenchyma showed diffuse delayed villous maturation, focal infarcts, and intraparenchymal hemorrhages. The decidua presented with chronic deciduitis with plasma cells. The parents declined the autopsy. Congenital syphilis is an emerging worldwide phenomenon and the multidisciplinary management of the mother and the fetus should be mandatory. Full article
(This article belongs to the Special Issue Infections in Pregnancy and Pathology Findings)
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